Do you have a toe that’s started to cross over or under its neighbor? If so, you have far more than just a cosmetic problem on your hands.
Overlapping and underlapping toes are more common than you might think. The most frequent situation is a pinky toe that crosses over or under the fourth toe. However, first or second toes are also relatively common.
As with most other deformities of the feet and toes, such as bunions or hammertoes, they are progressive conditions. Without treatment, they’ll only get worse over time.
Although you might not have any painful symptoms right now, it’s still wise to make an appointment with our team as soon as possible. Our preference is to help you manage your condition non-surgically if possible, and this approach is most likely to be effective if your overlapping or underlapping toe is less severe!
Common Symptoms of Overlapping Toes
The most obvious symptom, of course, is the physical appearance of the toes. Other accompanying symptoms may include:
- Pain and inflammation
- Corns and sometimes sores developing at points of friction—such as where the toes cross each other or rub against the inside of your shoe
- Difficulty wearing shoes comfortably
- Altered gait mechanics (which can lead to pain elsewhere in the feet, legs, and even lower back)
Again, it’s important to understand that even if you are currently only experiencing cosmetic symptoms, your condition is unlikely to remain that way if you don’t get help. So don’t wait for more severe problems to develop before you call us!
What Causes Overlapping or Underlapping Toes?
It’s not always exactly clear what causes overlapping or underlapping toes. However, it’s generally understood that the primary causes tend to be structural—in other words, the way your foot itself is shaped. Risk factors known to be associated with a greater chance of developing overlapping or underlapping toes include:
- Family history and genetics. If parents, grandparents, or other close relatives had this problem, you are more likely to develop it yourself. Furthermore, some children are simply born with overlapping or underlapping toes.
- Other foot deformities. Severe bunions can ultimately lead to the great toe crossing over the second toe, while severe bunionettes can do the same for the fifth toe. Likewise, the toe muscle imbalances that lead to hammertoes and mallet toes may also leave the toe susceptible to crossing over or under neighbors.
- Arch height. People with unusually high arches or flat feet often walk with somewhat altered biomechanics, which can increase the amount of destabilizing pressure on the joints at the base of toes.
- Having a long second toe. If your second toe is longer than your great toe, it is more likely to develop an overlapping or underlapping issue.
- Stiff tendons. These can keep the foot from fully flattening against the ground.
- Suffering a specific toe injury. A dislocated toe, for example, may cross over a neighbor.
But what about environmental factors, like wearing high heels or ill-fitting shoes? It’s not as clear that these problems can cause overlapping or underlapping toes all on their own, without an existing structural issue already present. However, they can definitely irritate your deformity and make the situation much worse, so they should still very much be avoided!
How Are Overlapping and Underlapping Toes Treated?
Again, given the progressive nature of conditions that lead to over and underlapping toes, it is important to seek treatment at the earliest possible stage. This increases the likelihood that conservative treatment methods will be effective at relieving symptoms and preventing the condition from worsening.
If the toes themselves remain fairly flexible and easy to move back into position with your fingers, you may be able to use toe separators, toe spacers, toe loops, buddy taping, or other similar tools to hold the toes in their correct position as you go about your day. Corn pads or protectors might also be recommended if you are developing corns on your toes as a result of your condition.
We will also, naturally, work to identify the root causes that are behind your toes becoming unstable and address those as well. This might involve the use of medical-grade inserts or custom orthotics, physical therapy, better shoes, and other treatments.
If conservative treatments are not sufficient to take away your pain and allow you to perform your hobbies and daily activities comfortably, surgical correction will typically be recommended. In most cases this is the only way to truly “fix” your overlapping or underlapping toe in a permanent way. If we recommend this course of treatment, we will carefully discuss the options with you so you can know what to expect and make any necessary arrangements to prepare for surgery and postoperative care.
Long Island Foot and Ankle Care
Foot Specialists of Long Island provides comprehensive foot and ankle care for all patients from across the greater Nassau County community. Contact us for more information by calling (516) 804-9038 or request an appointment online at our Massapequa, NY podiatrist office online today.